Department of Medical Sciences, Sports Physiology Laboratory, University of Cagliari, Via Porcell 4, Cagliari, Italy.
J Appl Physiol (1985). 2012 Oct 15;113(8):1323-31. doi: 10.1152/japplphysiol.00280.2012. Epub 2012 Jun 14.
A reduction in catecholamine levels during exercise has been described in young subjects with type 1 diabetes mellitus (DM1). It has been suggested that type 1 diabetes per se is associated with the loss of sympathetic response before any clinical evidence. Considering that an increase in sympathetic drive is required for normal cardiovascular response to muscle metaboreflex, the aim of this study was to assess the hemodynamics during metaboreflex in DM1 patients. Impedance cardiography was used to measure hemodynamics during metaboreflex activation, obtained through postexercise ischemia in 14 DM1 patients and in 11 healthy controls (CTL). Principal results were: 1) blunted blood pressure response during metaboreflex was observed in DM1 patients compared with the CTL; 2) reduced capacity to increase systemic vascular resistance was also witnessed in DM1 subjects; 3) DM1 subjects reported higher stroke volumes as a consequence of reduced cardiac afterload compared with the CTL, which led to a more evident cardiac output response, which partially compensated for the lack of vasoconstriction. These facts suggest that cardiovascular regulation was altered in DM1 patients and that there was a reduced capacity to increase sympathetic tone, even in the absence of any overt clinical sign. The metaboreflex test appears to be a valid tool to detect early signs of this cardiovascular dysregulation.
在 1 型糖尿病（DM1）的年轻患者中，运动期间儿茶酚胺水平降低已被描述。有人认为，1 型糖尿病本身与任何临床证据之前的交感神经反应丧失有关。考虑到正常心血管对肌肉代谢反射的反应需要增加交感神经驱动，本研究旨在评估 DM1 患者代谢反射时的血液动力学。阻抗心动描记法用于测量代谢反射激活期间的血液动力学，通过 14 名 DM1 患者和 11 名健康对照（CTL）的运动后缺血来获得。主要结果为：1）与 CTL 相比，DM1 患者在代谢反射时血压反应迟钝；2）DM1 患者的全身血管阻力增加能力也降低；3）DM1 患者的每搏量因心脏后负荷降低而增加，导致心输出量反应更为明显，部分补偿了血管收缩不足。这些事实表明，DM1 患者的心血管调节发生改变，即使没有任何明显的临床症状，增加交感神经张力的能力也降低。代谢反射测试似乎是一种有效的工具，可以检测这种心血管失调的早期迹象。
